Dear forum readers,
There is a wealth of knowledge among the forum posters and doctors who post here. Their collective experience can help many people who may have got undesired HT results.
We frequently come across patients requiring repair surgeries. For each such patient, there are often a variety of options. I discuss them with the patients and encourage them to go to discussion forums to see the choices made by other patients in a situation similar to theirs.
This not only gives them hope, it also helps them understand what final results they are likely to get if they decide to follow a particular course of action v/s another.
Following pictures are of one such patient.
I would encourage forum readers and fellow HT doctors to share their views on :
What are the particular specific problems in this case, and
What are the different options available to the patient?
Hopefully, this will help some patient making his own research.
This patient had got a so called FUE procedure somewhere else before he visited us.
Specific problems are hairline location. Does one opt to fill in the damaged area or should one attempt to raise the hairline? I would think any repair starts with a realistic placement of the hairline, which leads to a new set of problems from graft removal and scarring. Seems he still has plenty of donor, even though the old punch style extraction method was used
Dear forum readers,
One of the option for this patient would be reversal of the hair transplant performed.
This would involve extraction of the transplanted grafts and to place them back into the extraction scars in the scalp donor area.
This option while not exercised by most patients in a similar situation, is one that all should know exists.
Hello! We should sort out mistakes/faults in the previous hair transplant and then consider how these errors/mistakes would be solved. Problems with Previous FUE transplantation in the recipient area are
1-Tenting efect or skin elevation on the left frontal hairline.
2-Less density on the recipient site,may be less then 10 grafts/cm2 which gives see through effect or spacing between the hairs.
3- Angle and curvature of the hair shaft is not natural
4-Artificial look
5- Two hair in the frontal hairline at some points.
Donor Area Defects
1- Punch marks or extraction marks as bigger punch size is being used for extraction
Solutions for Such kind of bad hair transplant
Correction by strip method:
-we have to see if his hairline would be 0.5 cm lower and it would not give bad look and if it does not give then more single hair grafts on the front line so that his two faults could be corrected. A-see through effect B-Tenting or elevation effect
-We can also correct Elevation by CO2 Laser skin resurfacing on the frontal elevation and then proceed for corrective hair transplantation later on for more density.
-second option is to extract the frontal hairline grafts with 0.8mm or 0.9 mm punch and adjust them little up.
Correction of Donor Area
3- It is better to take strip from the donor area as there will be less spots of previous FUE in the donor area and secondly you have good number of grafts for frontal area.The closure should be with Tricophytic Technique.
The other option uses minimal/nil extraction of the previous grafts while placing new grafts around them in a more natural angle and direction.
The problem with this approach is that since some of the previous grafts are large and wrongly directed, they will not allow the correctly transplanted hair to lie perfectly. This is a compromise approach which does not give the ideal hair restoration but can be performed in a single session.
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